H.B. 1563

VETOES

(2) A CARRIER MAY ONLY ADJUST THE COMMUNITY RATE FOR THE
PURE PREMIUM PORTION OF THE PREMIUM RATE AND ONLY FOR:

(I) AGE; AND

(II) GEOGRAPHY BASED ON THE REGIONAL AREAS ESTABLISHED
UNDER § 737 OF THIS SUBTITLE.

(3) (I) A CARRIER MAY NOT ADJUST THE ADMINISTRATIVE EXPENSE
PORTION OF THE COMMUNITY RATE EXCEPT AS APPROVED BY THE COMMISSIONER.

(II) THE COMMISSIONER SHALL ADOPT REGULATIONS TO ALLOW
SEPARATE ADMINISTRATIVE EXPENSES FOR HEALTH BENEFIT PLANS, INCLUDING A
HEALTH BENEFIT PLAN SUBJECT TO SUBTITLE 55 OF THIS ARTICLE, OFFERED
THROUGH THE REGIONAL HEALTH COOPERATIVE AND OUTSIDE THE REGIONAL
HEALTH COOPERATIVE.

(4)      RATES FOR A HEALTH BENEFIT PLAN MAY VARY BASED ON FAMILY
COMPOSITION AS APPROVED BY THE COMMISSIONER.

(5)      A PARTICIPATING CARRIER SHALL ESTABLISH A SEPARATE
STATEWIDE COMMUNITY RATE FOR THE HEALTH BENEFIT PLAN AND
SUPPLEMENTAL BENEFITS OFFERED TO EACH OF THE FOLLOWING CLASSES OF
PURCHASERS:

(I) INDIVIDUALS;

(II) EMPLOYEES OF MEMBER EMPLOYERS SUBJECT TO SUBTITLE 55
OF THIS ARTICLE; AND

(III) EMPLOYEES OF MEMBER EMPLOYERS OTHER THAN THOSE
WHO ARE SUBJECT TO SUBTITLE 55 OF THIS ARTICLE.

(B) BASED ON THE ADJUSTMENTS ALLOWED UNDER SUBSECTION (A)(2) OF
THIS SECTION, A CARRIER MAY CHARGE A RATE THAT:

(1) FOR EMPLOYEES OF SMALL EMPLOYERS, MEETS THE

REQUIREMENTS OF SUBTITLE 55 OF THIS ARTICLE; AND

(2) FOR INDIVIDUALS AND EMPLOYEES OF EMPLOYERS OTHER THAN
THOSE SUBJECT TO SUBTITLE 55 OF THIS ARTICLE;

(I) IS 50% ABOVE OR BELOW THE COMMUNITY RATE FOR ANY
HEALTH BENEFIT PLAN ISSUED, DELIVERED, OR RENEWED BETWEEN JANUARY 1,
1996 AND DECEMBER 31, 1996;

(II) IS 40% ABOVE OR BELOW THE COMMUNITY RATE FOR ANY
HEALTH BENEFIT PLAN ISSUED, DELIVERED, OR RENEWED BETWEEN JANUARY 1,

1997 AND DECEMBER 31, 1997;

(III) IS 33% ABOVE OR BELOW THE COMMUNITY RATE FOR ALL
HEALTH BENEFIT PLANS ISSUED, DELIVERED, OR RENEWED BETWEEN JANUARY 1,

1998 AND DECEMBER 31, 1998; AND

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